Substance Use Comorbidity among Veterans with Posttraumatic Stress Disorder and Other Psychiatric Illness

Ismene L. Petrakis · Robert Alan Rosenheck · Rani A. Desai

148 citations0/0 files storedAmerican Journal on Addictions

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Posttraumatic Stress Disorder Research Substance Abuse Treatment and Outcomes Mental Health Treatment and Access

Abstract

There is considerable concern about the emergence of significant substance abuse among younger veterans of war in the Middle East, especially among those with Posttraumatic Stress Disorder (PTSD), but little information exists on the magnitude of this problem. Using national administrative data from the Department of Veterans Affairs (VA) (n = 1,001,996), we examined rates of diagnosed substance use disorders in Veterans who served in Iraq and Afghanistan diagnosed with PTSD compared to other psychiatric disorders; and compared rates among veterans of other service eras. Of VA patients with a selected mental disorder, 21.0% had a comorbid substance diagnosis. Veterans who served in the post-Vietnam era (VET) (1973-1991) had the highest rates of comorbidity. Logistic regression models indicated that veterans with each selected psychiatric diagnosis were significantly more likely to be dually diagnosed in comparison to veterans with PTSD; post-Vietnam veterans were significantly more likely to be dually diagnosed than veterans from other eras. Bipolar disorder and schizophrenia are most strongly associated with dual diagnosis in OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veterans. There are high rates of substance use disorders among veterans with mental illness. The highest rates of comorbidity occur among those with bipolar disorder and schizophrenia; and in post-VET veterans.

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References

1995Posttraumatic Stress Disorder in the National Comorbidity Survey 2001Substance Use Disorders in Patients With Posttraumatic Stress Disorder: A Review of the Literature 2007Bringing the War Back Home 2004Co-occurrence of 12-Month Alcohol and Drug Use Disorders and PersonalityDisorders in the United States 1996Current and Lifetime Psychiatric Disorders among Veterans with War Zone-Related Posttraumatic Stress Disorder 2009Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001

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